the chronicles of a med school student

 by Reza Corinne Clifton

"Even though I don't have a degree yet, the patients look at me like a doctor and like an example. Accordingly, I try to go to the gym and I try to stay fit. I think I'd be a hypocrite if I didn't go." - Marleny Franco

Marleny Franco is the focused type, and several years ago her focus was on attending medical school. I knew her back then.

She had just earned her undergraduate degree from Brown University in 2003; I had just completed mine from the University of Rhode Island. We were working together on a study - examining children with asthma and the differences in access to care, treatment, and preventative measures between White, Latino, and Black families. Previous research was showing more cases in Latino and African-American children as well as more instances of asthma-related deaths. Franco’s background and interest in medicine, her intellect and work integrity, and her own dual upbringing in the Dominican Republic and as an immigrant in Boston made her a highly valued member of the team.

It is nearly five years later and Franco is a third year student at Case Western Reserve University School of Medicine in Cleveland, Ohio. With the stress of the day-to-day pressures of scholastics and healthcare provision, and with it common knowledge that medical school is extra intense, I wondered how Franco was handling it. I spoke to her recently to get an idea.

It certainly was not easy to reach Franco as she neared the end of her sixth semester of medical school. One reason was because she was suddenly handling advanced responsibilities during her clinical hours – those expected of a fourth year student. Prior to that, she says, her role was “knowing everything about the patients [but] learning . . . from the residents and attending physicians.” Instead, she was now creating and implementing treatment.

But Franco knows how to cope with stress, I told myself, remembering the gym membership she created and utilized while living in Providence. And that is no different there in Cleveland, I learn, since it is during her car ride home after a class at her gym that I am able to catch her in the first place. Yet Franco is quick to dissolve the picture-perfect façade that her schedule helped to create in my mind.

"I almost didn’t go to the gym today,” she says. “I have to prepare for a presentation tomorrow,” she explains. But this was not an isolated instance of difficulty.

Where ideally, says Franco, she would go to the gym at least three times a week, she had spent months struggling to go just once weekly. “Why?” Couple the weighted, fourth-year responsibilities with the location and nature of her last assignment the – Pediatric Intensive Care Unit (PICU) – and the result is a recipe that doesn’t include much gym time, she says.

“PICU,” explains Franco, requires “a lot of reading” plus being on-call every fifth night from 7 a.m. one day to 2 p.m. – or later – the next. “I’ve never gotten more than three hours during [the 30 hour or more] on-call session, and I’m jealous if someone gets five during theirs,” explains Franco. Still, she is committed to exercising – as a form of stress-management and as a model for the patients she treats.

“Even though I don’t have a degree yet, the patients look at me like a doctor and like an example,” says Franco. “Accordingly, I try to go to the gym and I try to stay fit. I think I’d be a hypocrite if I didn’t go,” reflects Franco.

Yet, as demonstrated through the on-call hours required of her and other medical students, Franco’s personal health consciousness is not necessarily reflective of medical school culture.

“What’s surprised me the most,” says Franco, “is that health care professionals should be advocating good health – healthy eating, healthy sleeping . . . but for the most part, in your training as a medical school student, that’s not happening. You don’t need to be eating at 4 a.m. in the morning, but if you are, then you’re eating what’s available – a candy bar or a hamburger that you got before the cafeteria closed.”

I want to ask her what she usually chooses, but unfortunately I miss the opportunity. Focused as ever Franco has just pulled up to the house and presentation work awaits her.